Effects of dry needling combined with exercise on knee osteoarthritis at 6 month follow up a randomized clinical trial

Therapeutic exercise has been recommended for people with knee osteoarthritis; however, it can be combined with other treatments, such as dry needling. The aim of this study was to analyze and compare the results of pain, functionality, strength, range of motion and kinesiophobia in subjects with knee osteoarthritis, after treatment with dry needling of the popliteus muscle combined with an exercise program, compared to only performing an exercise program. This study was registered in the Clinical Trials Registry ClinicalTrials.gov (code: NCT06816940). A total of 38 participants were randomly divided into two groups: the experimental group, who conducted dry needling and therapeutic exercise (n = 18), and the control group, who performed therapeutic exercise and simulated dry needling (n = 20). The intervention lasted three weeks: dry needling was applied once per week, and the exercise program was performed four times per week. Variables such as pain, functionality, neuropathic pain, stiffness, range of motion, strength, pain catastrophizing and kinesiophobia were evaluated pre/post intervention and after 3/6 months. Significant between-group differences favoring the experimental group were observed, including maximum pain (VAS: mean change 30 [95% CI 18.4-42.0], p < 0.001) and functional disability (WOMAC: mean change 16.0 [95% CI 7.9-23.9], p < 0.001), with additional improvements observed in other measures. These findings suggest that popliteus muscle dry needling added to exercise showed better results in pain, functionality, strength, pain catastrophizing and kinesiophobia improvement in patients with knee osteoarthritis at 6-month follow-up compared to exercise alone.